Brief discussion of advantages and disadvantages of the use of composite endpoints in randomized control trials with examples.

1. 
Composite End Points
Kyle Gennaro

2. Overview
 Composite end point consists of two or more
component outcomes
 Participants that experience any of the events are
considered to experience the composite outcome

3. Advantages
 Statistical efficiency
 Prevents arbitrary selection between different
outcomes from a single disease process
 Broader evaluation of clinical benefit from an
intervention

4. Disadvantages
 Misleading – assumes the effect on the composite
outcome is similar amongst components
 Components can be of dissimilar importance
 Post hoc changes to the composite

5. Disadvantages - Misleading

6. Disadvantages - Misleading

7. Disadvantages – Dissimilar Importance

8. Disadvantages – Dissimilar Importance

9. Disadvantages – Dissimilar Importance

10. Disadvantages – Post hoc changes

11. Critically assessing composite endpoints
 Components are of similar importance to the
patient
 Components occur with similar frequency
 Components are affected to a similar degree

12. Sources
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outcomes in clinical trials: systematic review. BMJ. 2010;341:c3920.
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